Acute pancreatitis complicating severe dengue

Jain, Vikas; Op, Gupta; Rao, T.S. Sathyanarayana; Rao, Sruthi

doi:10.4103/0974-777x.132050

Cited by 25 publications

(27 citation statements)

References 6 publications

(6 reference statements)

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“…Conditions such as pancreatitis, neurological events, and haemorrhagic phenomena in spite of normal coagulation tests behaved differently from what had been classically described in the literature. 4 , 24 Pancreatitis in flavivirus has been described most frequently in cases of Dengue, 25 , 26 West Nile 27 , 28 and Rocio 29 virus infections. A fatal YF case with pancreatic involvement was recently described in a Chinese patient who had acquired this infection in Angola, 30 but pancreatic involvement due to YFV was not previously observed in rodent studies.…”

Section: Discussionmentioning

confidence: 99%

Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases

Casadio

Salles

Malta

et al. 2019

Mem. Inst. Oswaldo Cruz

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BACKGROUND Despite a highly efficacious vaccine, yellow fever (YF) is still a major threat in developing countries and a cause of outbreaks. In 2018, the Brazilian state of São Paulo witnessed a new YF outbreak in areas where the virus has not been detected before. OBJECTIVEThe aim is to describe the clinical and laboratorial characteristics of severe cases of YF, evaluate viral to determine markers associated with fatal outcome. METHODS Acute severe YF cases (n = 62) were admitted to the Intensive Care Unit of a reference hospital and submitted to routine laboratorial evaluation on admission. YFV-RNA was detected in serum and urine by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and then sequenced. Patients were classified in two groups: survival or death. FINDINGS In the univariate analysis the following variables were associated with outcome: alanin aminotransferase (ALT), aspartat aminotransferase (AST), AST/ALT ratio, total bilirubin (TB), chronic kidney disease epidemiology collaboration (CKD-EPI), ammonia, lipase, factor V, international normalised ratio (INR), lactate and bicarbonate. Logistic regression model showed two independent variables associated with death: lipase [odds ratio (OR) 1.018, 95% confidence interval (CI) 1.007 to 1.030, p = 0.002], and factor V (OR -0.955, 95% CI 0.929 to 0.982, p = 0.001). The estimated lipase and factor V cut-off values that maximised sensitivity and specificity for death prediction were 147.5 U/L [area under the curve (AUC) = 0.879], and 56.5% (AUC = 0.913).MAIN CONCLUSIONS YF acute severe cases show a generalised involvement of different organs (liver, spleen, heart, kidneys, intestines and pancreas), and different parameters were related to outcome. Factor V and lipase are independent variables associated with death, reinforcing the importance of hemorrhagic events due to fulminant liver failure and pointing to pancreatitis as a relevant event in the outcome of the disease.

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Section: Discussionmentioning

confidence: 99%

Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases

Casadio

Salles

Malta

et al. 2019

Mem. Inst. Oswaldo Cruz

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“…Our patient had severe dengue which was complicated by AP. The largest described series of DHF outbreak from Taiwan in 2002 reported three patients with AP while isolated cases have been reported from Thailand, Indonesia, New Caledonia, Colombia and India 3,4 .…”

Section: Discussionmentioning

confidence: 99%

“…The elevated enzymes, USG findings along with positive dengue NS1 antigen pointed towards the diagnosis. Meropenem and ceftriaxone were used to treat AP in DHF at different centres 4,6 . Our patient received ceftriaxone and responded well without developing any sequelae of AP.…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis complicating dengue fever - a case report

Rahman¹,

Wazib²,

Bahar

et al. 2020

SL J. Med.

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Dengue is a common arboviral infection in SouthEast Asia. It has various atypical manifestations; acute pancreatitis is one of them. Though the exact pathogenesis is not known, many mechanisms have been postulated. We present a case of a 32-year-old lady who presented with fever, upper abdominal pain and vomiting. She was subsequently diagnosed to have acute pancreatitis (AP) due to dengue fever (DF). She was treated conservatively for dengue fever and recovered completely. In DHF abdominal pain is an alarming feature. Though less common, AP should be kept in mind as a cause of acute abdominal pain in dengue.

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“…In some cases, gastrointestinal involvement in dengue may present as acute abdomen and that may lead to diagnostic dilemma to physicians as well as to surgeon. There have also been reports of presentation of dengue as surgical emergencies such as acute pancreatitis,7 acute acalculous cholecystitis, acute appendicitis and perforation peritonitis8 due to gastric perforation,9 jejunal perforation10 or appendicular perforation 11…”

Section: Discussionmentioning

confidence: 99%

Ileal perforation associated with dengue in the paediatric age group: an uncommon presentation

et al. 2016

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Acute abdomen in dengue, a common arboviral disease found in tropical and subtropical countries, is not uncommon and can occasionally present as acute surgical emergency requiring urgent surgical intervention. The spectrum of acute abdomen presenting as surgical emergency in dengue infection that raises suspicion of an abdominal catastrophe includes acute appendicitis, acute cholecystitis, appendicitis and, rarely, intestinal perforation. All cases of intestinal perforation including appendicular, gastric and jejunal perforation have been reported in adult patients during the course of dengue infection. However, intestinal perforation during the course of dengue infection in the paediatric age group has never been reported. We report two cases of ileal perforation in children occurring during the course of dengue infection.

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Acute pancreatitis complicating severe dengue

Cited by 25 publications

References 6 publications

Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases

Lipase and factor V (but not viral load) are prognostic factors for the evolution of severe yellow fever cases

Acute pancreatitis complicating dengue fever - a case report

Ileal perforation associated with dengue in the paediatric age group: an uncommon presentation

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